DAVID STINE HERIFORD Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****29

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

STINE

Last Name

HERIFORD

Business Name

DAVID STINE HERIFORD

Original Issue Date

05/12/2006

Effective Date

12/14/2007

Expiration Date

03/01/2010

City

VIRGINIA

State

Zip

62691

County

CASS

Ever Disciplined

LastModifiedDate

11/18/2010

Case Number

2005006424

Action

Probation

Discipline Start Date

05/12/2006

Discipline End Date

05/12/2008

Discipline Reason

Disciplined in the state of Washington.